While I awaited the results of my biopsies (The Beginning) I couldn’t help but wonder what would happen when they came back positive. From the dermatologist’s reaction there seemed little doubt that they would. What would the next step be? Who was going to take them off? What would the procedure be like? I went back for my followup and sure enough all of the biopsy sites were positive. Basal cell and squamous cell cancer the dermatologist told me. He told me that on my way out the woman at the front desk would have a list of doctors that they could refer me to. And indeed she did.
“We have two physicians that we usually refer skin cancer patients to”, she started. “This first one is a plastic surgeon. He’s good but he’s a real asshole.” Some choice there I thought wryly. “The other one is a mohs surgeon. Our patients seem very happy with him.” There you have it I thought. Happy on the one hand. Asshole on the other. But what, I wondered, was mohs surgery? Remembering the rather insensitive slur from my youth I wondered would it turn me into a ‘mo or was it the sort of thing that only ‘mos went to? Time for some research.
The web was nothing like we know it today, no Wikipedia or anything like that, but I was able to use it to find out that Mohs Micrographic Surgery was a technique for removing skin cancer in layers. It was created, or pioneered if you will, by Dr. Fredrick E. Mohs in 1936 at the University of Wisconsin. With my ever expanding knowledge base I now had to decide. Plastic surgeon, and that conjured up good repair and no scarring in my book, on the one hand and Mohs Surgery on the other. I opted for Mohs but I was nervous and unsure all the same.
I called Cary Skin Center and scheduled an appointment for surgery with Dr. Robert E. Clark. The doctor people were happy with. No asshole for me by golly. The surgery was scheduled for two weeks down the road (a busy place apparently) and at a very ungodly time of the morning. I had a lot of time to let my imagination wander at the possibilities of this surgery. And wander it did. While I had made some friends in the physician profession I still was not comfortable when I was the patient. Those two weeks could not pass quickly enough.
Pass they did though and I arrived at the appointed time and place.
I walked through the front door and was greeted by a woman whose name tag indicated that she was Ingrid. Friendly, but also sort of stern and reserved. Kind of like her name. She made a copy of my insurance card, gave me what seemed like a mountain of paperwork to fill out and told me to take a seat. The waiting room was very spacious. High, wide open ceilings with glass and plenty of light. A big TV was situated in front of a sofa a chairs just to the left of what looked to be a nurses station. There was an urn of coffee on one of the tables with plenty of Cary Skin Center mugs. A water cooler and glasses were available if you weren’t the coffee type. As I settled in to fill out the paperwork I looked around at my fellow patients and my first impression was “my God, I must be in the wrong place. Look at how old all of these people are!” I was at least 20 years younger than any other patient in the waiting room. I guess cancer doesn’t really care about how old you are.
I finished filling out the paperwork, got up from my chair, walked back to the front desk and handed it over to Ingrid. Someone would come and take me back for surgery she informed me. Lucky me. I headed back to my seat and didn’t have long to wait. A nurse came walking around the sofa, introduced herself, and escorted me back to one of the surgical rooms. We exchanged pleasantries as she got me settled in. She looked over the paperwork I had filled out earlier.
“No stranger to skin cancer are you?”
“No, unfortunately not”, I replied.
“Ever had Mohs?” she asked, making it sound more like a disease than a procedure. Maybe penicillin would cure it I thought to myself.
“Never have”, I said.
“Do you have any allergies?”
“Only to pain and blood”, I told her. A hint of a smile showed at the corner of her mouth.
“How about lidocaine or latex?” Latex ‘eh? Maybe I’d stumbled into some sort of a sex shop and didn’t know it.
“No, neither one.”
“Very good. Make yourself comfortable and someone will be with you shortly”, she said.
After she left the room I took a few minutes to get the lay of the land. I was sitting in one of two chairs that were side by side, sandwiched between a desk on one side and a counter on the other. The desk had a 17 inch flat screen monitor, a digital card reader, a business card holder with six different cards represented, a few stray magazines and a Compaq computer securely chained under the desk. Must have a dicey clientele, I thought, if they had to lock down the PCs. Never knew when one of the octogenarians would put one under their overcoat and walk off I suppose.
The counter had a sink flanked by containers holding qtips, gauze pads, latex gloves and other assorted surgical goodies. There was antibacterial soap, a paper towel dispenser and next to the towel dispenser was a bio hazard container for scalpel blades and syringes. There were several drawers and a couple of cabinets underneath those. No telling what they housed but I could guess and I figured that I’d know for certain in due time.
Next to the desk was a window that ran from floor to ceiling. It consisted of a number of privacy panes and only a few panes that you could actually see through. In front of the window was a stainless steel tray on a base with rollers. It was covered with a blue surgical drape that was laden with instruments, gauze, syringes and lidocaine. Next to that was a chair of sorts. It was covered with a white sheet and had a pillow and a maroon towel on it. There were four foot pedals behind it that controlled raising and lowering the foot and head part of the chair as well as raising and lowering the chair itself. Clearly this thing cost more than most people made in a year. Hanging on the wall next to the chair were a digital thermometer, a blood pressure device and a cauterization tool. Let the games begin I thought as I heard the door opening.
“Hi. I’m Paul Toth”, he said extending his hand as he entered the room. “I’m Dr. Clark’s PA.”
“I’m Gregg Morris”, I said as I shook his hand.
“Dr. Clark will be with you shortly. In the meantime, can I answer any questions for you?”
He could not have been more genial and his bedside manner was very comforting. We talked a bit and then we were joined by the nurse who proceeded to take my vitals and get me to sign the surgical consent forms. You know, the ones that say if they screw up it’s your fault. I signed and shortly thereafter Dr. Clark came in and explained what he was going to do and how the morning would proceed. He could not have been more professional or more comforting than he was. Soft spoken but very direct and very confident. I could tell within minutes that I had made the right choice in coming to Cary Skin Center. I may have been unlucky with the skin cancer but I was unbelievably lucky to have Dr. Clark to see me through it.
